Pulmonary Complications of HIV Infection : Autopsy Findings

Affiliations: From the Division of Critical Care, Department of Medicine, Howard University, Washington, DC.,
From the University of Florida Health Science Center, Jacksonville, and the Department of Pathology, Department of Medicine, Howard University, Washington, DC.,
From the Department of Pathology, Howard University, Washington, DC.,
From the Division of Infectious Diseases, Department of Medicine, Howard University, Washington, DC.

Affiliations: From the Division of Critical Care, Department of Medicine, Howard University, Washington, DC.,
From the University of Florida Health Science Center, Jacksonville, and the Department of Pathology, Department of Medicine, Howard University, Washington, DC.,
From the Department of Pathology, Howard University, Washington, DC.,
From the Division of Infectious Diseases, Department of Medicine, Howard University, Washington, DC.

Affiliations: From the Division of Critical Care, Department of Medicine, Howard University, Washington, DC.,
From the University of Florida Health Science Center, Jacksonville, and the Department of Pathology, Department of Medicine, Howard University, Washington, DC.,
From the Department of Pathology, Howard University, Washington, DC.,
From the Division of Infectious Diseases, Department of Medicine, Howard University, Washington, DC.

Affiliations: From the Division of Critical Care, Department of Medicine, Howard University, Washington, DC.,
From the University of Florida Health Science Center, Jacksonville, and the Department of Pathology, Department of Medicine, Howard University, Washington, DC.,
From the Department of Pathology, Howard University, Washington, DC.,
From the Division of Infectious Diseases, Department of Medicine, Howard University, Washington, DC.

Abstract

Study objectives: To describe the pulmonary complications in patients with HIV infection, and the changes in the incidence of these complications over a 12-year period.

Design: Retrospective review of autopsy records.

Setting: Two university-affiliated medical centers.

Patients: We studied autopsy findings from 233 patients with HIV infection who died between 1985 and 1996. Demographic data, risk factors for HIV infection, and the lengths of hospital stay were obtained. The histologic and microbiological findings of the respiratory system, and the extrapulmonary organ involvement by Kaposi's sarcoma (KS), Pneumocystis carinii, Mycobacterium tuberculosis, and Mycobacterium avium complex were reviewed.

Results: Ninety-two percent ofthe patients were black and 75% were male. The two most common identified risk factors for HIV infection were homosexuality (34%) and injection drug use (27%). Bacterial pneumonia was the most frequent pulmonary complication (42%). The two most common causes of bacterial pneumonia were Pseudomonas aeruginosa and Staphylococcus aureus. P carinii pneumonia (PCP) was found in 24%, with extrapulmonary involvement in 13%. Pulmonary mycobacterial infections were seen in 33%, with multiple extrapulmonary involvement. The most common site affected by KS was the lung. Of all pulmonary complications, only the incidence of PCP decreased over the 12-year period.

Conclusions:Recognizing the high incidence rate of bacterial pneumonia, the high frequency of pulmonary KS and the not uncommon occurrence of extrapulmonary P carinii infection in patients with HIV helps in improving their care.

Copyright in the material you requested is held by the American College of Chest Physicians (unless otherwise noted).
This email ability is provided as a courtesy, and by using it you agree that that you are requesting the material
solely for personal, non-commercial use, and that it is subject to the American College of Chest Physicians’ Terms of Use.
The information provided in order to email this topic will not be used to send unsolicited email, nor will it be
furnished to third parties. Please refer to the American College of Chest Physicians’ Privacy Policy for further information.

Forgot your password?

Enter your username and email address. We'll send you a reminder to the email address on record.

Username
(required)

Email Address
(required)

Athens and Shibboleth are access management services that provide single sign-on to protected resources. They replace the multiple user names and passwords necessary to access subscription-based content with a single user name and password that can be entered once per session. It operates independently of a user's location or IP address. If your institution uses Athens or Shibboleth authentication, please contact your site administrator to receive your user name and password.